Pet dogs suffering from heart disease could live 15 months longer according to groundbreaking new research released today.
The global EPIC study, led by Professor Adrian Boswood of the Royal Veterinary College, has found that treatment with the drug pimobendan delays the onset of heart failure secondary to mitral valve disease (MVD), the most common form of heart disease in dogs.
The results, published in the Journal of Veterinary Internal Medicine, found that treating dogs with enlarged hearts – an early warning sign of progressive heart disease – before they displayed any outward signs of the condition delayed the onset of heart failure by an average of 15 months, with dogs that received the drug also living significantly longer than those receiving a placebo.
Evidence was so conclusive, the study was terminated early following an interim analysis as it was deemed unethical to continue to withhold treatment from the placebo group.
Heart disease is one of the top five causes of death of dogs in the UK1, with MVD accounting for the majority of cases. The disease is caused by the deterioration of one of the heart valves and predominantly affects small breed dogs, including Cavalier King Charles Spaniels, Dachshunds, Miniature Poodles and terrier breeds. It is also a common condition in elderly humans.
It’s crucial that all owners get their dog’s heart checked regularly by their vet. This is especially true for small breed dogs over the age of 7 years old, as this is when the risk increases.
Professor Boswood described why regular heart health checks are so important for dogs: “The vast majority of dogs with this heart disease will show no signs of the problem for quite some time, although they may have a heart murmur. This makes it crucial that all owners get their dog’s heart checked regularly by their vet. This is especially true for small breed dogs over the age of 7 years old, as this is when the risk increases.
“The exception is Cavalier King Charles spaniels, who are around 20 times more prone to this heart disease and can be affected much earlier in life, from around 5 years old, so need to be checked earlier and more regularly.”
The EPIC (Evaluating Pimobendan in Cardiomegaly) study is the most robust of its kind in veterinary medicine, taking 7 years to complete and working to the highest standards of clinical research, rivalling that of human trials. There were 360 dogs involved in the study, across 11 countries and 4 continents, making the results relevant for dogs and owners across the world.
A recent survey of dog owners found that more than half (53%) of small breed dog owners did not think their dog was at risk of developing heart disease, despite MVD being more prevalent in these breeds3. However, more than one in three (34%) would want to do anything possible to prevent their pet from developing the signs of heart disease.
Broadcaster Gloria Hunniford owns two cavalier King Charles spaniels; Roxy who is 4 and Gemma who is 8: “Our beautiful dog Gemma was diagnosed with a heart condition after she collapsed earlier this year, but before that we saw no real signs that she might be unwell – thankfully she’s doing well with the right medication.
“Knowing first-hand the effects of this disease, the fact that there’s now something that owners can do to help protect their dogs from the effects is fantastic news. I’m sure that, for most owners, there would be no question about taking the opportunity to give their dog the chance of a longer, healthier life.”
Jenny Jackson, owns 13-year-old Cavalier King Charles spaniel, Alfie, who took part in the EPIC trial: “I found out by chance that Alfie was diagnosed with a heart condition at one of his routine check-ups. They discovered he had a grade 4 heart murmur and was referred to the RVC where he was recommended to take part in the trial.
“Alfie has been a constant source of companionship since my husband died of cancer in 2009. Alfie has been there through it all, when I first started seeing my new partner Craig and then when my daughter Ellie was born.
“Since taking part in the trial, Alfie’s heart murmur has dropped to a grade 3 which is a significant milestone for his health. The results have been very positive as he became leaner and more agile; it is as if he had stopped aging.”*
It can be relatively easy for a vet to detect suspected MVD, but an ultrasound scan and radiograph (x-ray) may be required to decide whether a dog will benefit from treatment. Pet owners are urged to speak to their vet about the risk of heart disease in their dog, especially if they own a small breed dog over the age of 7 years or a cavalier King Charles spaniel over 5 years old.
EPIC Study Case Study – Jenny Jackson
Jenny Jackson, from Bedfordshire, owns a 13-year-old Cavalier King Charles spaniel called Alfie. Alfie was diagnosed with preclinical MVD when he was 8 years old at the Royal Veterinary College where they established he had a grade 4 heart murmur.
Alfie has been part of Jenny’s family since he was 10 weeks old. Jenny knew she wanted to own a Cavalier since she fell in love with a family friend’s dog of the same breed. “I wanted a lap dog, which was gentle in nature and a Cavvie was the perfect breed for me,” she explained.
Although he has slowed down a bit with age and is slightly deaf now, Alfie is very much a treasured part of the family.
“When we got Alfie, although I had grown-up step children, I didn’t have any children of my own so he was my baby. Tragedy struck the family in 2009 when I lost my husband to cancer. For a while it was just me and Alfie, but his companionship helped to keep me going through the tough times.
“He just fitted in to whatever happened in my life. Alfie has been there through it all, when I first started seeing my new partner Craig and then when my daughter Ellie was born. He is a constant and reliable source of love and affection. He and Ellie have become very close, like brother and sister.”
Jenny described the day she found out Alfie had developed preclinical MVD: “I found out that Alfie had preclinical MVD by chance, it was at a routine visit to the vets and they discovered Alfie had a grade 4 heart murmur. I was then referred to a cardiologist specialist at the RVC where it was discovered that Alfie had preclinical MVD.”
When Jenny first discovered Alfie had preclinical MVD, she was concerned for Alfie’s health, but she was aware that Cavalier King Charles spaniels were predisposed to this condition.
“I was prepared for Alfie to have heart disease as I had done my research about the breed when Alfie was a puppy, but I had not heard of the term MVD in dogs, only in humans and I was worried for Alfie’s health. As a loving dog owner, you want to know what the prognosis is for your dog, and you want to know the extent of the problem early on if possible. You love them all the same though no matter what their condition is, and I would try anything to help Alfie. Alfie has done well health-wise for a Cavvie for his age and we expected at some point to see some effects of heart disease.”
Jenny found out about the EPIC trial during one of Alfie’s regular heart check-ups at the RVC.
“Adrian Boswood, Professor of Cardiology at the RVC suggested that Alfie should take part in the trial. He said Alfie was the right dog to take part in terms of breed, age and diagnosis. We thought, what did we have to lose? We had to take part and give Alfie a chance.”
To take part in the EPIC trial, Alfie had to have his heart beats recorded the week before his check-up. During the trial period, Alfie had check-ups every four months and be administered a tablet each day – ½ in the morning, ½ in the evening.
“Alfie was a good little patient and enjoyed the stroking and attention that staff were giving him,” Jenny added. “He was so laid back that I believe on occasion the hospital didn’t need to sedate him for X-rays. It was a great feeling to take part in the trial, we were so glad that there was something we could do for Alfie. The mere fact that his heart was monitored so closely by experts at the RVC (every 4 months) was a huge benefit in itself.”
Within a few months of starting the trial, Alfie’s murmur had gone down a grade, which was remarkable. The trial finished and despite what the vets originally said, Alfie has outlived the study.*
Jenny said the trial has affected Alfie’s health for the better: “Firstly the fact that the grade went from a 4 to 3 was a significant milestone in terms of what was going on inside Alfie. He also started to show positive results as he became leaner and more agile; it was as if he had stopped aging. Even now, he looks like a much younger dog than 13 (almost 14). He sleeps a lot more and is a bit stiff when he first wakes up, but after a good stretch he’s fine. He has never fainted since, never developed a cough or been significantly out of breath. His appetite is ‘greedy’ given half a chance, although he is on a strict diet! The only sign of ageing is the fact that he appears to be a slightly deaf now.”
Jenny added: “I definitely think it’s important to know what you’re dealing with when it comes to your dog’s health, and to do your research when you decide to own a specific dog breed. You can then prepare yourself to take appropriate action when needed. It does become an education process for owners, but when you take on a dog that is predisposed to certain diseases, you need to do the best for them. I think the overwhelming results that have come out of the EPIC study are so important and good news for dog owners. Knowing that there is something out there that these dogs can now take to help extend their life is truly amazing. It is lovely to know that Alfie will be by my side for longer.”
“Having Alfie be involved in such a ground-breaking study in canine cardiology is such an honour. I like to think Alfie has left a legacy in some way.”
Alfie is now on a management programme developed by the RVC to control his MVD.
*(N.B, Jenny does not know if Alfie was on the placebo or pimobendan)
For more information about the EPIC study:
1. D.G. O’Neill, D.B. Church, P.D. McGreevy, P.C. Thomson, D.C. Brodbelt (2013). Longevity and mortality of owned dogs in England, The Veterinary Journal Volume 198, Issue 3, December 2013, Pages 638–643
2. OnePoll Survey of 2000 UK Dog Owners, September 2016